| NPI | 1528355765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60628646) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 6564) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2016-04-05 |